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Thursday, November 7, 2013

Advocates Seek More Info on Timetable for Cutting Adults off BadgerCare

Six health care advocacy groups sent a letter to the Walker Administration today seeking information on the state’s plans relating to BadgerCare if the online portal for the new health insurance Marketplace continues to have significant problems. WCCF was one of the six groups – along with Community Advocates Public Policy Institute, ABC for Health, Mental Health America of Wisconsin, Wisconsin Alliance for Women’s Health and the Wisconsin Primary Health Care Association – expressing concern that the state ought to have a backup plan so tens of thousands of current BadgerCare participants don't find themselves uninsured in January.

As I noted in a blog post yesterday, DHS Secretary Kitty Rhoades said just a week ago that “moving forward with the Wisconsin model was tied to the exchanges being operational.”
She accurately described the intent of a Joint Finance Committee
amendment to the budget bill, but that amendment contains a provision
that appears to negate the intended effect. (See our blog post about the failed failsafe.) With that in mind, WCCF joined with the five other groups to find out what the state’s contingency plans are.

A WI State Journal article by David Wahlberg today does an excellent job of summarizing the letter and the preliminary DHS reaction. Rather than reiterating those points, I’d like to expand upon both the article and the letter by outlining several of the other reasons why the state ought to delay ending the insurance coverage of at least 77,000 BadgerCare participants on January 1:The DHS determinations of eligibility later this month will be flawed because they are based on incomplete information – The computer problems aren’t just in the federal online portal. Because state officials dragged their feet in preparing for ACA implementation, the large computer run a couple of weeks from now to determine BadgerCare eligibility won’t be consistent with the revised definitions of income and family size. For example, some people who have child support income will incorrectly appear to have too much income for the adults to be eligible. (Read more here.)

Even if the computer system problems are eliminated within the next week or two, there are other impediments – Getting people enrolled in coverage through the Marketplace often isn’t as simple as enabling them to go online and complete an application. Many will need to spend time with a navigator or assister to help them understand their options, and additional time may be needed in the application process to verify income or to confirm that the applicant doesn’t have an offer of affordable employer-sponsored coverage. Our state hasn’t trained nearly enough navigators and assisters to cope with so many people having to complete the full application and enrollment process within such a short period of time.

BadgerCare participants are just one of the groups who will be adversely affected – In addition to the direct effects of sticking to the January 1 timetable for the eligibility changes, there are very substantial indirect effects. As I’ve noted on many previous occasions, the state’s timeline maximizes the logjam this month and next, as too many people try at the same time to get assistance in figuring out their options and getting enrolled. That will make it much harder to provide sufficient assistance for the 25,000 people losing their current coverage in the state’s high risk plan (HIRSP), and for tens of thousands of people who are already uninsured. Because the HIRSP participants often have significant chronic conditions, it is particularly reprehensible that the state’s choices will make it difficult for that vulnerable population to get adequate enrollment assistance.

On many occasions this year, Governor Walker and other state officials have said their plans will nearly cut in half the number of uninsured state residents. To achieve that commendable goal, a good place to start is to stick to the budget bill’s promise that the BadgerCare changes will be “tied to the exchanges being operational.” The state and federal computer problems and the limited number of people assisting with enrollment make it clear that the new Marketplace won’t truly be operational in the sense of being able to handle such a huge deluge of cases before the Dec. 15 deadline for paying premiums.